EP2147693B1 - Vorrichtung zur Erkennung und Behandlung von Herzversagen - Google Patents
Vorrichtung zur Erkennung und Behandlung von Herzversagen Download PDFInfo
- Publication number
- EP2147693B1 EP2147693B1 EP09166164.5A EP09166164A EP2147693B1 EP 2147693 B1 EP2147693 B1 EP 2147693B1 EP 09166164 A EP09166164 A EP 09166164A EP 2147693 B1 EP2147693 B1 EP 2147693B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- heart failure
- patient
- failure condition
- processor
- respiratory
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Not-in-force
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/0826—Detecting or evaluating apnoea events
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/0816—Measuring devices for examining respiratory frequency
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/087—Measuring breath flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/087—Measuring breath flow
- A61B5/0873—Measuring breath flow using optical means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
- A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
- A61B5/14552—Details of sensors specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
- A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
- A61M16/0666—Nasal cannulas or tubing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
- A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
- A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0036—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the breathing tube and used in both inspiratory and expiratory phase
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/18—General characteristics of the apparatus with alarm
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3303—Using a biosensor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/35—Communication
- A61M2205/3546—Range
- A61M2205/3561—Range local, e.g. within room or hospital
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/35—Communication
- A61M2205/3576—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver
- A61M2205/3584—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver using modem, internet or bluetooth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/35—Communication
- A61M2205/3576—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver
- A61M2205/3592—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver using telemetric means, e.g. radio or optical transmission
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
- A61M2205/502—User interfaces, e.g. screens or keyboards
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/04—Heartbeat characteristics, e.g. ECG, blood pressure modulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/04—Heartbeat characteristics, e.g. ECG, blood pressure modulation
- A61M2230/06—Heartbeat rate only
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/202—Blood composition characteristics partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/30—Blood pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/63—Motion, e.g. physical activity
Definitions
- the present technology relates to methods and apparatus for detecting and treating the condition of heart failure.
- a common cause of heart failure is hypertension (i.e., high blood pressure).
- Another common cause of heart failure is coronary artery disease (e.g., a heart attack).
- Other structural or functional causes of heart failure include:
- Heart failure is more common with advancing age. Risk factors for developing heart failure include being overweight, having diabetes, smoking cigarettes, abusing alcohol, or using cocaine.
- SV stroke volume
- EV end-diastolic volume
- EF ejection fraction
- Echocardiography may also be used to identify valvular heart disease and assess the state of the pericardium (i.e., the connective tissue sac surrounding the heart). Echocardiography may also aid in deciding what treatments will help the patient, such as medication, insertion of an implantable cardioverter-defibrillator or cardiac resynchronization therapy.
- Chest X-rays are another frequently used tool for diagnosing CHF. In the compensated patient, this may show cardiomegaly (a visible enlargement of the heart), quantified as the cardiothoracic ratio (a proportion of the heart size to the chest). In left ventricular failure, there may be evidence of vascular redistribution ("upper lobe blood diversion” or “cephalization"), Kerley lines, cuffing of the areas around the bronchi, and interstitial edema.
- An electrocardiogram may be used to identify arrhythmias, ischemic heart disease, right and left ventricular hypertrophy, and presence of conduction delay or abnormalities (e.g. left bundle branch block). These results may be evaluated in making a diagnosis of heart failure.
- Blood tests may also be used to diagnose the condition. For example, measures of electrolytes (sodium, potassium), measures of renal function, liver function tests, thyroid function tests, a complete blood count, and often C-reactive protein if an infection is possible, may be used to diagnose the patient's condition.
- measures of electrolytes sodium, potassium
- measures of renal function measures of renal function
- liver function tests measures of renal function
- thyroid function tests a complete blood count
- One specific test for heart failure determines the level of B-type natriuretic peptide (BNP).
- BNP B-type natriuretic peptide
- An elevated level of BNP may suggest the existence of heart failure.
- the BNP level may differentiate heart failure as a cause of dyspnea from other conditions that may cause dyspnea. If myocardial infarction is a possibility, cardiac markers may be used in the diagnosis of heart failure.
- a patient's heart failure condition may be the result of coronary artery disease.
- the condition may depend on the ability of the coronary arteries to provide blood to the myocardium.
- a coronary catheterization may also help to identify possibilities for revascularization through percutaneous coronary intervention or bypass surgery.
- Different measures may be determined to assess the progress of a patient's heart failure condition.
- a fluid balance or calculation of fluid intake and excretion can assist in monitoring a patient's condition.
- changes in body weight, which may reflect fluid shifts can be considered.
- the Framingham criteria which was derived from the Framingham Heart Study, the Boston criteria, the Duke criteria and the Killip classification are systems that are commonly considered in evaluating a patient for heart failure.
- a functional classification of heart failure may also be considered by classes defined by the New York Heart Association Functional Classification (NYHAFC).
- NYHAFC New York Heart Association Functional Classification
- a score according to this classification system grades the severity of symptoms, and can be used to assess the patient's responses to treatment. While it is commonly used, the NYHAFC score may not be reliably reproducible.
- the classes (I-IV) of the NYHAFC system are:
- WO 2005/037355 A1 relates to a method and a corresponding apparatus for assessing the condition of and treating patients for heart failure by the delivery of continuous positive airway pressure.
- An aspect of certain example embodiments of the present technology relates to a system for detecting the presence of, or a change in condition (e.g., worsening) of Congestive Heart Failure.
- this involves an apparatus for determining and monitoring a respiratory parameter of a patient.
- the apparatus monitors a change in the pattern of apneas and/or hypopneas of a patient and/or a change in Cheyne-Stokes breathing.
- the apparatus may determine a change or worsening of a condition of the patient upon an increase in the number and/or duration of apneas, hypopneas and/or Cheyne-Stokes breathing.
- a method involves evaluating a heart failure condition of a patient by measuring a respiratory airflow of the patient and then determining a heart failure condition change indicator based on the respiratory airflow.
- the indicator represents information about a heart failure condition of the patient.
- a system monitors a patient to evaluate a heart failure condition of a patient.
- a typical system may include a patient interface and a flow sensor coupled thereto. The flow sensor generates a respiratory airflow signal representative of the patient's respiratory airflow from the patient interface.
- a processor of the system is configured to control a determination of the heart failure condition indicator based on data from the respiratory airflow signal.
- a device or apparatus monitors a patient to evaluate a heart failure condition of a patient.
- the apparatus or device may include a patient respiratory interface with a sensor coupled with the patient interface.
- the sensor generates a signal representative of the patient's respiratory airflow.
- a processor which may be coupled with the flow sensor, controls a determination of a heart failure condition indicator based on the respiratory airflow signal.
- a warning signal, warning light or warning message may be generated to inform a patient/user of the technology and/or a physician treating the patient.
- the warning signals, warning lights or messages of the embodiments may be generated and transmitted between devices to permit remote monitoring and notification of the patient's heart failure condition.
- the warning signals, warning light and/or warning messages will typically be triggered by the evaluation of the heart failure condition indicators.
- Some embodiments of the present technology involve a method for evaluating a heart failure condition of a patient during respiratory pressure treatment.
- the method may include determining a measure of treatment pressure delivered by a respiratory treatment apparatus with a sensor. It may further include determining a heart failure condition change indicator with a processor based on the measure of pressure.
- the method may still further include determining a measure of respiration of the patient with a sensor, wherein the determining of the heart failure condition change indicator is further based on the respiration measure.
- the determining of the indicator may optionally include a threshold comparison that detects an increase in a proportion of the measure of pressure and an increase in an apnea or AHI count during a common time period.
- the method may also involve controlling of a change to a pressure treatment therapy of a respiratory treatment apparatus in response to one or more determined indicators. This change in control may optionally involve initiating control of ventilation support to meet a target ventilation.
- some embodiments may involve an apparatus for evaluating a heart failure condition of a patient during respiratory pressure treatment.
- the apparatus may include a sensor to determine a measure of treatment pressure delivered by a respiratory treatment apparatus.
- a processor of the apparatus may determine a heart failure condition change indicator based on the measure of pressure.
- the processor may also be configured to determine a measure of respiration of the patient with data from a sensor so that the processor can determine the heart failure condition change indicator based on the respiration measure.
- the processor may implement a threshold comparison that detects an increase in a proportion of the measure of pressure and an increase in an apnea or AHI count during a common time period.
- the apparatus may include a flow generator coupled with the processor such that the processor may be configured to control a change to a pressure treatment therapy of the respiratory treatment apparatus in response to the determined indicator. Such a change may be initiating control of ventilation support to meet a target ventilation.
- the present technology involves methods and devices for the treatment of patients at risk for heart failure or congestive heart failure or changes in the condition of these diseases.
- congestive heart failure exacerbation is also known as decompensated heart failure (DHF).
- DHF decompensated heart failure
- acute decompensation results in pulmonary oedema. Treatment of this condition will typically require hospitalization for the patient.
- the potential for acute decompensation is caught early enough, such as at the earliest stages of the onset of pulmonary oedema, it may be treated in a manner that does not require hospitalization.
- the heart failure condition indicator of the devices of the present technology provides a basis for detecting such changes in congestive heart failure and for notifying the patient or medical providers of the potential need for medical intervention with respect to the heart failure condition of the patient.
- the heart failure detection device 100 implements a heart failure condition change indicator (referenced in FIG. 1 as "HFCI").
- the heart failure detection device 100 will typically include a patient respiratory interface 102, a controller 104 and a flow sensor 106.
- the patient respiratory interface which will typically include a cannula 108 and/or sense tube 110, receives and/or senses airflow from the patient's respiratory system via the patient's mouth and/or the patient's nares.
- the patient respiratory interface may be implemented with a nasal mask, nose & mouth mask, full-face mask or nasal pillows.
- the flow sensor 106 may be coupled with the patient respiratory interface.
- the flow sensor generates a signal representative of the patient's respiratory flow.
- flow proximate to the nasal cannula 108 or sense tube 110 may be measured using a pneumotachograph and differential pressure transducer or similar device such as one employing a bundle of tubes or ducts to derive a flow signal f(t).
- a pressure sensor may be implemented as a flow sensor and a flow signal may be generated based on the changes in pressure.
- the flow sensor 106 is illustrated in a housing of the controller 104, it may optionally be located closer to the patient, such as in the nasal cannula 108 or sense tube 110. Other devices for generating a respiratory flow signal may also be implemented.
- the heart failure detection device 100 may also include additional diagnosis sensors 112.
- the device may include an oximeter.
- the oximeter may generate a signal representative of a blood oxygen level of a patient.
- a suitable example oximeter or monitor device may optionally be any of the devices disclosed in International Patent Application No. International Application No. PCT/AU2005/001543 (Pub. No. WO/2006/037184 ) or International Patent Application No. PCT/AU1996/000218 (Pub. No. WO/1996/032055 ).
- the monitor may serve as diagnosis sensors that can also optionally provide a blood pressure and/or pulse rate monitor for measuring a pulse rate and/or blood pressure of the patient.
- the diagnosis sensors may also include an ECG monitor such as the LifeScreen Apnea monitor provided by BiancaMed.
- ECG monitor such as the LifeScreen Apnea monitor provided by BiancaMed.
- a device may be configured to detect cardiac-related characteristics (e.g., ECG signals) and determine respiratory parameters (such as central or obstruction apneas, hypopneas, etc.) and other parameters (e.g., arrhythmias) that may be experienced by the patient by analyzing the ECG signals from the patient.
- these parameters may be determined by the analysis algorithms of controller 104 based on transmission of the ECG data to the controller or they may be determined by the monitor and be transmitted to the controller 104.
- the diagnosis sensors may also or alternatively include an ultrasonic screening sensor for detecting obstructive or central apneas by non-contact sensing.
- the sensor may monitor sound such as by the use of ultrasonic sensors to detect obstructive or central apneas, hypopneas and other respiratory parameters from the signals measured by the sensors.
- Such non-contact based measures may then be implemented for monitoring of the patient's condition as discussed in more detail herein.
- the data from the sensors may be transmitted to the controller 104 for use and analysis by the controller.
- Such a sensor may be implemented in a heart failure detection device of the present technology without the use of a contact-based sensor or without the use of a mask or cannula that may otherwise be used with a flow sensor for a more direct measure of patient airflow. Thus, in this embodiment no patient intervention is required for the diagnosis sensing.
- the diagnosis sensors may include a movement sensor.
- a suprasternal notch sensor or chest band may be implemented to generate a movement signal that is indicative of patient respiration.
- Other suitable sensors may include the movement sensing devices disclosed in International Patent Application No. PCT/AU1998/000358 (Pub. No. WO/1998/052467 ).
- the movement sensors thus may provide a measure of patient respiration and may be used as an alternative to a flow sensor or in conjunction with other flow sensors in the determination of respiratory parameters as discussed herein.
- the signals from the sensors may be sent to the controller 104.
- Optional analog-to-digital (A/D) converters/samplers may be utilized in the event that supplied signals from the sensors are not in digital form and the controller is a digital controller.
- the controller assesses the changing heart failure condition of the patient with one or more heart failure condition indicators HFCI.
- the controller may optionally include a display device 116 such as one or more warning lights (e.g., one or more light emitting diodes).
- the display device may also be implemented as a display screen such as an LCD. Activation of the display device 116 will typically be set by the controller based on an assessment of the particular heart failure condition change indicators implemented by the heart failure detection device 100.
- the display device may be implemented to visually show information to a user of the heart failure detection device 100 or a clinician or physician.
- the display device 116 may also show a graphic user interface for operation of the heart failure detection device 100. User, clinician or physician control of the operation of the heart failure detection device 100 may be based on operation of input switches 118 that may be sensed by the controller or processor.
- the controller may also include a communications device 120 for receiving and/or transmitting data or messages by the heart failure detection device 100.
- the communications device may be a wireless transceiver such as Bluetooth or WIFI transceiver.
- the communications device may also be a network communications device such as a phone modem and/or network card and may be implemented to send messages via the internet directly or through a computer to which the heart failure detection device may be docked.
- the communications device 120 may be used to transmit warnings or messages to a clinician or physician assessable apparatus 122 such as a multi-patient monitoring system that allows a physician to review data from remote patient data recording devices such as the heart failure detection device 100.
- a database is provided to record patient monitoring data. Physicians or clinicians may receive a report, or warning that the patient may require closer observation, or should be brought to hospital.
- the controller 104 will also typically include a processor 114 configured to implement particular control methodology such as the algorithms described in more detail herein.
- the controller may include integrated chips, a memory and/or other control instruction, data or information storage medium.
- programmed instructions encompassing such a control methodology may be coded on integrated chips in the memory of the device.
- Such instructions may also or alternatively be loaded as software or firmware using an appropriate data storage medium.
- the device can be used for determining and analyzing many different parameters associated with the patient's condition based on data from the sensors.
- the processor may control the assessment of a heart failure condition indicator HFCI or heart failure condition change indicator as described in the embodiments discussed in more detail herein.
- the heart failure detection device 100 may monitor respiratory-related characteristics such as the patient respiratory airflow with at least one of the flow sensors or a respiratory-related characteristic deriving device as previously described. For example, in step 200 the respiratory airflow of the patient may be measured and provided to a processor of the controller.
- the heart failure detection device will then determine one or more respiratory-based parameters from the measure of respiratory airflow or other sensor data in step 202.
- a respiratory parameter may be a respiratory rate, number of apneas, a number of hypopneas or an Apnea-Hypopnea Index (AHI).
- the processor may analyze patterns of patient data, such as patterns of the airflow signal, patterns of an ECG signal, etc., to detect occurrences of apneas and/or hypopneas. Methods and apparatus for detecting apneas and hypopneas are described in US Patent 5, 704, 345 .
- An “apnea” may be considered a cessation of breathing by the patient for more than 10 seconds.
- a hypopnea may be defined as a reduction in ventilation to between about 30% to about 70% of normal ventilation.
- the AHI may be calculated as the number of apneas and hypopneas in a particular time period such as an hour, in a day or during a particular sleep session. Other forms of an AHI may also be implemented.
- the processor may also be configured to determine a number of Cheyne-Stokes breaths during a particular time interval such as an hour, in a day or a particular sleep session.
- One suitable measure may be the detection of a number of Cheyne-Stokes epochs.
- An example methodology for a detection of Cheyne-Stokes epochs from a flow signal is described in International Patent Application No. PCT/AU2005/001942 (Pub. No. WO/2006/066337 ).
- CSR Cheyne-Stokes Respiration
- oximetry may be utilized to assess a presence of CSR.
- the controller 104 will then compare one or more of the determined respiratory parameters and/or patient parameters to one or more thresholds.
- each threshold is chosen so that the results of the comparison indicate a change in the heart failure condition of the patient such as the patient beginning to experience an onset of acute decompensation.
- a determined respiratory parameter such as the AHI may be compared to a prior AHI for the patient or an average AHI for the patient from a previous time frame, such as one or more prior monitoring sessions.
- a present change to the AHI (such as an increase or a decrease or a certain amount of increase or decrease) over a previous determined AHI may be taken as a heart failure condition change indicator.
- an increase of ten or more may be considered indicative of a change in the heart failure condition of the patient.
- More complex thresholds indicative of changes in the AHI may also be assessed as the heart failure condition change indicator. For example, increases in the AHI for two or more consecutive days of monitoring sessions may be taken as the heart failure condition change indicator HFCI.
- the thresholds may be selected to consider how significant the change or increases are in AHI such as ignoring small changes or small increases (e.g., 2 or fewer).
- a heart failure change indicator may be based on the determined Cheyne-Stokes breathing patterns or epochs and one or more thresholds. For example, a count of Cheyne-Stokes epochs from a current session may be taken as the respiratory parameter and may be compared to a prior count of Cheyne-Stokes epochs for the patient or an average number of epochs for the patient from a previous time frame, such as one or more prior monitoring sessions. A present change to the epoch count (such as an increase or a decrease or a certain amount of increase or decrease) over a previous determined epoch count may be taken as a heart failure condition indicator.
- Still more complex thresholds indicative of changes in the epoch may also be assessed as the heart failure condition indicator. For example, increases in the epochs for two or more consecutive days of monitoring sessions without a comparable decrease over the same consecutive day time frame in the following days may be taken as the heart failure condition indicator.
- a heart failure indicator may be based on the results of the comparison of several thresholds and several respiratory parameters or patient parameters. For example, an increase in the AHI over several sessions coupled with an increase in the Cheyne-Stokes epoch count over several sessions may collectively be taken as a heart failure condition change indicator.
- one or more of the heart failure condition indicators may also be based on a threshold comparison involving measures of heart rate, blood pressure and/or blood-oxygen levels.
- a measured ratio of O 2 to CO 2 as it changes over time may be compared to a threshold such as a prior measure of the ratio.
- a certain level of change in the measure may be considered a heart failure change indicator.
- Still other patient parameters or measures may also be implemented as a heart failure change indicator with the present technology.
- Suitable examples may include heart-rate variability metrics (e.g., measures of sympathovagal balance), cardio pulmonary coupling (e.g., correlation of pulse and breathing), arterial CO 2 tension (e.g., non-invasive estimate via trans-cutaneous CO 2 or end-tidal CO 2 ) and/or one or more photoploethysmogram-derived indices (e.g., relative respiratory effort and/or variation thereof, arterial stiffness, cardiopulmonary coupling, HRV, etc.).
- heart-rate variability metrics e.g., measures of sympathovagal balance
- cardio pulmonary coupling e.g., correlation of pulse and breathing
- arterial CO 2 tension e.g., non-invasive estimate via trans-cutaneous CO 2 or end-tidal CO 2
- photoploethysmogram-derived indices e.g., relative respiratory effort and/or variation thereof, arterial stiffness, cardiopulmonary coupling, HRV, etc.
- one or more of these patient parameters or measures may be compared with one or more thresholds. The results of one or more of these comparisons may then serve as a heart failure change indicator or may be combined with one or more other respiratory-based parameters to serve as a heart failure condition change indicator. For example, a decrease in an average pulse rate of a patient over several sessions combined with an increase in a number of epochs during the same sessions may be taken as a heart failure condition indicator.
- Thresholds associated with these patient parameters such as the respiratory-based parameters may be determined through empirical analysis of the conditions and changes experienced by congestive heart failure patients.
- An apparatus or device in accordance with the invention provides a convenient way to monitor patients and may even be utilized while they sleep.
- the heart failure condition change indicators may be used to trigger the device to provide a warning or message in a form suitable for the patient and/or clinicians to be aware of the status of the patient's heart so that the patient may more efficiently receive the care that is necessary.
- the warning or messaging of the system may take a number of forms.
- the controller in response to an affirmative heart failure condition change indicator, may activate a status light (e.g., an LED or an icon on a display screen or LCD) of the monitoring device.
- a status light e.g., an LED or an icon on a display screen or LCD
- a more detailed message concerning the assessment of the indicator may also be displayed on the display screen.
- the controller may also, or alternatively, send a message to a clinician of physician.
- Such a message may take the form of a wired or wireless communication.
- the controller may generate a message via a paging system such as by automatically dialing a paging system.
- the controller may also be configured to generate an automated voice phone call message.
- the controller may also send the message by a fax transmission.
- the controller may also send a message via any internet messaging protocol, such as an email message, or by any other internet data file transport protocol.
- the messages may even be encrypted to keep patient information confidential.
- a typical message may identify the patient.
- Such a message may also include the data of the changes recorded by the system any other recorded patient information.
- the message may even express that the patient should be considered for additional heart failure treatment or an evaluation due to the detection of a potential decompensation event.
- an example embodiment of a display or warning that may be presented to a patient or physician by the device may be a warning message such as a graphic or textual message.
- the message may be displayed on the device or a remote device based on the evaluation of one or more of the programmed heart failure condition change indicators HFCI.
- the warning message may be based on an increase in the measured Cheyne-Stokes epochs count (e.g., an increase of more than 20 units or some other number of units from a set of previous days counts (e.g., two days)).
- the warning message may also be based on an increase in the AHI index (e.g., an increase by more than 10 units or some other number of units from a set of previous days indices (e.g., two days)). Such a heart failure condition indicator(s) could trigger the message(s). Still optionally, the message may also be based on a collective combination of the two example increases such that the message is triggered only when both conditions are met.
- an increase in the AHI index e.g., an increase by more than 10 units or some other number of units from a set of previous days indices (e.g., two days)
- Such a heart failure condition indicator(s) could trigger the message(s).
- the message may also be based on a collective combination of the two example increases such that the message is triggered only when both conditions are met.
- graded levels of warning messages may also be generated to describe the patient's heart failure condition as multiple different heart failure condition indicators or a repeated heart failure condition indicator collectively triggers the different messages based on the severity of the detected conditions. For example, one heart failure condition indicator may trigger an initial warning message on a certain day. However, a different message, such as one with a higher level of urgency, may be generated by a second and different heart failure condition indicator on a subsequent day based on the previously illustrated collective condition that involves both the AHI and the Cheyne-Stokes epoch respiratory parameters. In such an embodiment, after the first message, the second message may more urgently warn that the patient should immediately contact a physician for a medical examination. In this manner, the device may monitor or store data concerning each warning so that the warnings may be progressively altered or generated based on prior warnings and/or heart failure change indicators.
- the messages could be directed more selectively.
- the first message may be only transmitted to a physician or clinician by only transmitting the message to a physician system 122 through the communications device 120 without showing it on the display device 116.
- the second message which may be a more urgent message, could then be actively displayed on the display device 116 in addition to transmitting it to the physician system 122.
- An audible alarm from an optional speaker controlled by the controller of the device may also be implemented. Use of an audible alarm may depend on the urgency of the message.
- the heart failure condition indicator technology may be included in a monitoring device such as the heart failure detection device 100, the technology may also be combined with other devices.
- the technology may be implemented in devices used for monitoring other patient conditions.
- the technology may be implemented in such diagnosis or screening devices as the APNEA LINK (ResMed), EMBLETTA (Flaga), RUSleepingTM (Respironics) and the E-series (Compumedics) etc.
- a non-contact sleep monitoring device such as a non-contact AHI screener (e.g., BiancaMed biomotion sensor, which detects movement, respiration, respiratory effort, and/or heart rate via low power pulses of radio frequency energy.)
- a non-contact AHI screener e.g., BiancaMed biomotion sensor, which detects movement, respiration, respiratory effort, and/or heart rate via low power pulses of radio frequency energy.
- the heart failure detection device may be implemented in respiratory treatment devices.
- the technology may be implemented in automatic diagnosis and treatment devices such as the ResMed AUTOSET series of devices including the AUTOSET CS, and adaptive servo ventilation devices, such as the ResMed VPAP Adapt SV.
- FIG. 3 illustrates a respiratory treatment device that may implement the technology described herein.
- the monitoring and treatment device 400 may serve as the heart failure detection device 100.
- the device may include a patient respiratory interface 402, such as a mask 409 and delivery tube 410, like the device of FIG. 1 .
- the delivery tube 410 may serve as the sense tube 110.
- the monitoring and treatment device may also include a flow sensor 406, a controller 404, display device 416, switches 418, communications device 420 and diagnosis sensors 412 comparable to the components previously described with respect to the device of FIG. 1 .
- the device may also communicate generated messages to the physician system 422 as previously discussed.
- the monitoring and treatment device 400 of FIG. 3 may also optionally be configured to provide a respiratory pressure treatment from a flow generator such as a servo-controlled blower 424.
- the device may further include a pressure sensor 106, such as a pressure transducer to measure the pressure generated by the blower 102 and generate a pressure signal p(t) indicative of the measurements of pressure.
- the controller 404 Based on flow f (t) and pressure p(t) signals, the controller 404 with a processor 414 generates blower control signals. For example, the controller may generate a desired pressure set point and servo-control the blower to meet the set point by comparing the setpoint with the measured condition of the pressure sensor. Thus, the controller 404 may make controlled changes to the pressure delivered to the patient interface by the blower 102. Optionally, such changes to pressure may be implemented by controlling an exhaust with a mechanical release valve (not shown) to increase or decrease the exhaust while maintaining a relatively constant blower speed.
- the apparatus can be used for many different pressure treatment therapies, such as the pressure treatments for sleep disordered breathing, Cheyne-Stokes Respiration or obstructive sleep apnea (e.g., CPAP, APAP, Bi-Level CPAP, Auto-VPAP, etc.) by adjusting a suitable pressure delivery equation.
- pressure treatment therapies such as the pressure treatments for sleep disordered breathing, Cheyne-Stokes Respiration or obstructive sleep apnea (e.g., CPAP, APAP, Bi-Level CPAP, Auto-VPAP, etc.) by adjusting a suitable pressure delivery equation.
- a patient is diagnosed with congestive heart failure and may be at a risk of experiencing acute decompensation.
- the patient is evaluated for Sleep Disordered Breathing (SDB) or determined if the patient is being treated for SDB. If the patient does not have this condition, the patient may be provided a heart failure treatment device 100 in step 538 for use, such as during the patient's sleep.
- the patient may be evaluated for Cheyne-Stokes Respiration (CSR) or Obstructive Sleep Apnea (OSA).
- CSR Cheyne-Stokes Respiration
- OSA Obstructive Sleep Apnea
- the patient would be provided a device capable of generating treatment pressures for addressing CSR in step 536.
- the patient would be provided a device capable of generating treatment pressures for addressing OSA in step 534.
- each of the devices would monitor and analyze information based on the patient's respiration to determine the respiratory based parameters as previously discussed with respect to the algorithm of FIG. 2 .
- the thresholds of one or more heart failure condition indicators would be evaluated. If a heart failure condition indicator suggests that the patient is experiencing a worsening or change of the heart failure conduction such as a decompensation event, a warning would be triggered in step 544.
- the present technology may be realized in different devices depending on the needs of the patient while taking advantage of the existing components of other devices that the patient may need.
- the assessed heart failure condition indicator may also be based on a measure of pressure associated with a respiratory treatment generated by a treatment apparatus such as, for example, an adaptive servo ventilator or other respiratory treatment device that detects and responds to respiratory events such as central apneas, hypopneas and/or obstructive apneas (e.g., an auto-titrating SDB apparatus, auto-end expiratory pressure (EEP) setting apparatus and/or a device that measures ventilation and maintains a target ventilation).
- a measure of pressure associated with a respiratory treatment generated by a treatment apparatus such as, for example, an adaptive servo ventilator or other respiratory treatment device that detects and responds to respiratory events such as central apneas, hypopneas and/or obstructive apneas (e.g., an auto-titrating SDB apparatus, auto-end expiratory pressure (EEP) setting apparatus and/or a device that measures ventilation and maintains a target
- treatment pressure may then be determined based on the pressure measure.
- Example treatment pressure measures may include a peak inspiratory pressure, proportion of delivered pressure treatment, median pressure, and/or a level of pressure support, etc. These measures may be determined by the device on a session by session basis or some other time period. For example, such a measure may be determined by monitoring a 95th percentile pressure delivered during a treatment session as described in U.S. Patent No. 7,100,608 assigned to ResMed Ltd. and filed on Jan. 4, 2002.
- Such measures may be monitored and compared to one or more suitable thresholds to provide a heart failure condition indication in 604.
- the history of such measures may be considered over days or months.
- one or more of these measures and suitable threshold(s), such as a certain amount of change in one or more sessions when compared to one or more prior sessions may serve as the indicator.
- the indicator may be based on a recent trend indicating increases in one or more pressure measures from a prior period of time or prior treatment session or sessions and may result in the triggering of a warning in 608.
- the indicator based on an increase or a trend of increases in pressure may be combined with an indicator based on changes in an apnea and/or hypopnea count during a common set of treatment sessions.
- a moderate or small increase or increasing trend in an AHI and/or an apnea count (shown as "AI" in FIG. 6 ) (e.g., obstructive apnea and/or central apnea) by an amount coupled with an increase or an increasing trend in a treatment pressure measure may serve as a combined heart failure condition indicator if detected during a similar time period.
- Such a warning that may be generated by a device based on a several session increase in both 95 th percentile pressure and either AHI or AI is illustrated in FIG. 6 .
- the device may optionally generate a report showing or illustrating the analyzed measures that are associated with the particular heart failure change indicator.
- the positive indication of a detection of decompensation from one or more heart failure condition indicators may be implemented to control an automated change in a treatment therapy provided by a respiratory treatment apparatus as illustrated at 608 in FIG. 5 .
- the treatment control methodology of the device may modify control of the flow generator to change a pressure response of the device.
- a modification in treatment therapy protocol may be implemented.
- the change in control may cause the respiratory treatment apparatus to begin to control pressure changes so that a measure of ventilation meets a target ventilation.
- a processor of a treatment apparatus may servo-control the flow generator to deliver a pressure treatment that satisfies the target ventilation.
- a target ventilation may be predetermined by a physician or automatically set with a learning mode of a respiratory treatment device.
- a respiratory treatment device will typically measure delivered ventilation and adjust the pressure being supplied to the patient in a manner to ensure that the measured ventilation satisfies the target ventilation.
- the flow generator will compensate with an increase or decrease respectively in the supplied pressure support.
- an automatically setting SDB device e.g., an auto-titrating CPAP or Bi-level device
- a negative indication subsequent to a positive indication may return the pressure treatment control protocol from a ventilation target enforcing protocol to an auto-titrating SDB protocol.
- positive indications of decompensation may be implemented to control a modification of the target for ventilation enforcement.
- the target may be increased based on additional detections of decompensation.
- a device which enforces a calculated target ventilation e.g., 90% of a long term ventilation measure
- a predetermined e.g., clinician prescribed
- heart failure condition indicator technology has been described in several embodiments, it is to be understood that these embodiments are merely illustrative of the technology. Further modifications may be devised within the spirit and scope of this description.
- a monitoring device may simply measure the respiratory data of the patient and transfer the data to another processing system.
- the second processing system may in turn analyze the respiration data to determine the respiratory parameters used in an analysis of the present technology.
- the second processing system may also evaluate the heart failure condition indicators and generate warning messages as described herein, such as by sending one or more of the described messages, in electronic form for example, back to the patient monitoring device for display on the device to warn the patient.
- the apparatus or system may also determine a change that is representative of improvement of a heart failure condition of the patient. For example, a decrease in the number and/or duration of apneas, hypopneas, Cheyne-Stokes breathing and/or any other determined change to any respiratory parameters and/or patient parameters may serve as one or more heart failure condition indicators as previously discussed. A suitable message may then be generated based thereon to inform the user and/or physician of the potential need to revise the patient's medical treatment (e.g., a reduction in heart failure related medication, reduction or change in pressure treatment or pressure treatment protocol, etc.) due to the patient's improvement.
- a change that is representative of improvement of a heart failure condition of the patient For example, a decrease in the number and/or duration of apneas, hypopneas, Cheyne-Stokes breathing and/or any other determined change to any respiratory parameters and/or patient parameters may serve as one or more heart failure condition indicators as previously discussed. A suitable message may
- the detected improvement may even serve as a control to a change in treatment such as, for example, a change to a pressure treatment setting or a pressure treatment protocol of a respiratory treatment apparatus.
- an indication of improvement may control a change from a protocol that delivers respiratory support to maintain a ventilation target to one that does not, such as a SDB device that treats Cheyne-Stokes Respiration or obstructive sleep apnea (e.g., CPAP, APAP, Bi-Level CPAP or other device that detects apnea and/or obstructive events and sets a treatment pressure to treat the detected event.)
- Cheyne-Stokes Respiration or obstructive sleep apnea e.g., CPAP, APAP, Bi-Level CPAP or other device that detects apnea and/or obstructive events and sets a treatment pressure to treat the detected event.
- a method for evaluating a heart failure condition of a patient may comprise: determining a measure of respiration of the patient; and determining with a processor a heart failure condition change indicator based on the respiration measure, the indicator representing information about a change in a heart failure condition of the patient.
- determining of the heart failure condition indicator comprises a threshold comparison of a respiratory parameter determined from a measure of respiratory airflow.
- the threshold comparison involves a threshold representative of a change to the respiratory parameter that is indicative of acute decompensation.
- the method of any of the prior paragraphs may further comprise generating a warning based on the heart failure condition change indicator.
- warning comprises an activated light
- the method of any of the prior paragraphs may further comprise transmitting an electronic message including data representing a result of the determining of the heart failure condition indicator.
- the method of any of the prior paragraphs may further comprise delivering breathable gas at a pressure above atmospheric to the patient during the measuring of the respiratory airflow.
- determining of the heart failure condition indicator may comprise a plurality of threshold comparisons involving a plurality of respiratory parameters determined from the measure of respiratory airflow.
- the respiratory parameters comprise data representative of one or more apneas and hypopneas experienced by the patient and data representative of one or more Cheyne-Stokes epochs experienced by the patient.
- the method of any of the prior paragraphs may further comprise determining a heart failure condition change indicator based on data determined by an ultrasonic sensing device.
- the method of any of the prior paragraphs may further comprise determining a heart failure condition change indicator based on a determined heart-rate variability metric.
- the method of any of the prior paragraphs may further comprise determining a heart failure condition change indicator based on a measure of sympathovagal balance.
- the method of any of the prior paragraphs may further comprise determining a heart failure condition change indicator based on a measure of gas of a patient's blood.
- the method of any of the prior paragraphs may further comprise determining a heart failure condition change indicator based on a measure derived from a photoploethysmogram.
- a device for monitoring a patient to evaluate a heart failure condition of a patient may comprise: a patient interface; a sensor to generate a signal associated with a characteristic of patient respiration; and a processor, coupled with the sensor, where the processor is configured to control a determination of a heart failure condition change indicator based on the characteristic of respiration, such that the indicator represents information about a change in a heart failure condition of the patient.
- the processor is configured to perform a threshold comparison of a respiratory parameter determined by the processor from the characteristic of respiration, and wherein a result of the comparison triggers a heart failure condition message.
- the threshold comparison involves a threshold representative of a change to the respiratory parameter that is indicative of acute decompensation.
- the respiratory parameter is an apnea-hypopnea index.
- the respiratory parameter is a Cheyne-Stokes breathing pattern index.
- warning comprises a light signal or a message.
- the message comprises an electronic message to be transmitted.
- the device of any of the prior paragraphs may further comprise a transmitter coupled with the processor, wherein the processor is further configured to control transmitting of a message including data representing the heart failure condition indicator.
- the device of any of the prior paragraphs may further comprise a flow generator coupled to the processor and the patient interface, wherein the processor is configured to control generating a flow of breathable gas at a pressure above atmospheric to the patient interface.
- the processor is configured to determine the heart failure condition change indicator with a plurality of threshold comparisons involving a plurality of respiratory parameters determined from a measure of respiratory airflow and wherein the characteristic of respiration is the measure of respiratory airflow.
- the respiratory parameters comprise data representative of one or more apneas and hypopneas experienced by the patient and data representative of one or more Cheyne-Stokes epochs experienced by the patient.
- the processor is configured to determine the heart failure condition change indicator with a threshold comparison involving a an oximetery measure and wherein the characteristic of respiration is the oximetery measure.
- the device of any of the prior paragraphs may further comprise an ultrasonic sensing device and wherein the processor is configured to determine a heart failure condition change indicator based on data determined by the ultrasonic sensing device.
- the processor is configured to determine a heart failure condition change indicator based on a determined heart-rate variability metric.
- the processor is configured to determine a heart failure condition change indicator based on a measure of sympathovagal balance.
- the processor is configured to determine a heart failure condition change indicator based on a measure of gas of a patient's blood.
- the device of any of the prior paragraphs may further comprise a photoploethysmograph to derive the measure of gas.
- An apparatus for monitoring a patient to evaluate a heart failure condition of the patient may comprise: sensor means for determining a measure of a respiration characteristic of the patient; respiration analysis means for determining a respiratory parameter based on the measure generated by the sensor means; and analysis means for evaluating at least the respiratory parameter to generate a heart failure condition change indicator representing a change in a congestive heart failure condition of the patient.
- the apparatus of any of the prior paragraphs may further comprise means for transmitting a message representing the heart failure condition change indicator.
- the apparatus of any of the prior paragraphs may further comprise means for warning a user of the system based on the heart failure condition change indicator.
- the apparatus of any of the prior paragraphs may further comprise a means for delivering pressurized breathable gas to the patient.
- the apparatus of any of the prior paragraphs may further comprise means for warning a physician of the system based on the heart failure condition change indicator.
- a system for monitoring a patient to evaluate a heart failure condition of a patient may comprise: a patient interface; a flow sensor coupled with the patient interface, the flow sensor to generate a respiratory airflow signal representative of the patient's respiratory airflow; and a processor configured to control a determination of a heart failure condition change indicator based on data from the respiratory airflow signal, the indicator representing information about a change in a heart failure condition of the patient.
- the processor is configured to perform a threshold comparison of a respiratory parameter determined by the processor from the data of the respiratory airflow signal, wherein a result of the comparison triggers a heart failure condition message.
- the threshold comparison involves a threshold representative of a change to the respiratory parameter that is indicative of acute decompensation.
- warning comprises a light activation signal.
- warning comprises an electronic message to be transmitted, the message including data representing the heart failure condition change indicator.
- the system of any of the prior paragraphs may further comprise a flow generator coupled to the patient interface, wherein the flow generator is configured to generate a flow of breathable gas at a pressure above atmospheric to the patient interface.
- the processor is configured to determine the heart failure condition indicator with a plurality of threshold comparisons involving a plurality of respiratory parameters determined from the measure of respiratory airflow.
- respiratory parameters comprise data representative of one or more apneas and hypopneas experienced by the patient and data representative of one or more Cheyne-Stokes epochs experienced by the patient.
- the system of any of the prior paragraphs may further comprise an ultrasonic sensing device and wherein the processor is configured to determine a heart failure condition change indicator based on data determined by the ultrasonic sensing device.
- the processor is configured to determine a heart failure condition change indicator based on a determined heart-rate variability metric.
- the processor is configured to determine a heart failure condition change indicator based on a measure of sympathovagal balance.
- the processor is configured to determine a heart failure condition change indicator based on a measure of gas of a patient's blood.
- a method for evaluating a heart failure condition of a patient during respiratory pressure treatment may comprise: determining a measure of treatment pressure delivered by a respiratory treatment apparatus with a sensor; and determining a heart failure condition change indicator with a processor based on the measure of pressure, such that the indicator represents information about a change in a heart failure condition of the patient.
- the method of any of the prior paragraphs may further comprise: determining a measure of respiration of the patient with a sensor; and wherein the determining of the heart failure condition change indicator is further based on the respiration measure.
- the determining of the heart failure condition change indicator comprises a threshold comparison that detects an increase in a proportion of the measure of pressure and an increase in an AHI or apnea count during a common time period.
- the method of any of the prior paragraphs may further comprise controlling a change to a pressure treatment therapy of the respiratory treatment apparatus in response to the heart failure condition change indicator.
- An apparatus for evaluating a heart failure condition of a patient during respiratory pressure treatment may comprise: a sensor to determine a measure of treatment pressure delivered by a respiratory treatment apparatus; and a processor to determine a heart failure condition change indicator based on the measure of pressure, the indicator representing information about a change in a heart failure condition of the patient.
- the processor is configured to determine a measure of respiration of the patient with data from a sensor; and wherein the processor is configured to determine the heart failure condition change indicator based on the respiration measure.
- the processor implements a threshold comparison that detects an increase in a proportion of the measure of pressure and an increase in an apnea or AHI count during a common time period.
- the apparatus of any of the prior paragraphs may further comprise a flow generator coupled with the processor and wherein the processor is configured to control a change to a pressure treatment therapy of the respiratory treatment apparatus in response to the heart failure condition change indicator.
- the change to the pressure treatment therapy comprises initiating control of ventilation support to meet a target ventilation.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Physics & Mathematics (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Biophysics (AREA)
- Physiology (AREA)
- Epidemiology (AREA)
- Primary Health Care (AREA)
- Emergency Medicine (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Cardiology (AREA)
- General Business, Economics & Management (AREA)
- Databases & Information Systems (AREA)
- Business, Economics & Management (AREA)
- Data Mining & Analysis (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Spectroscopy & Molecular Physics (AREA)
- Optics & Photonics (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
Claims (15)
- Vorrichtung (100) zur Überwachung eines Patienten, um ein Herzinsuffizienzleiden eines Patienten zu bewerten, die aufweist:eine Patientenschnittstelle (102);einen Sensor (106), der konfiguriert ist, ein Signal zu erzeugen, das mit einer Eigenschaft der Atmung des Patienten verknüpft ist; undeinen Sensor, der konfiguriert ist, ein Signal zu erzeugen, das für einen respiratorischen Behandlungsdruck repräsentativ ist, undeinen Prozessor (114), der mit dem Sensor (106) gekoppelt und konfiguriert ist, das Signal zu erzeugen, das mit einer Eigenschaft der Atmung des Patienten verknüpft ist, wobei der Prozessor (114) konfiguriert ist, eine Bestimmung eines Indikators für eine Änderung des Herzinsuffizienzleidens beruhend auf einem Maß des respiratorischen Behandlungsdrucks und einem respiratorischen Parameter zu steuern, der aus der Eigenschaft der Atmung bestimmt wird, wobei der Indikator Informationen über eine Änderung eines Herzinsuffizienzleidens des Patienten repräsentiert;wobei der Prozessor (114) konfiguriert ist, einen Schwellenwertvergleich des durch den Prozessor (114) bestimmten respiratorischen Parameters durchzuführen, und wobei ein Ergebnis des Vergleichs eine Herzinsuffizienzleidensnachricht auslöst.
- Vorrichtung (100) nach Anspruch 1, wobei der Schwellenwertvergleich einen Schwellenwert einbezieht, der für eine Änderung des respiratorischen Parameters repräsentativ ist, der eine akute Dekompensation anzeigt.
- Vorrichtung (100) nach Anspruch 1, wobei der bestimmte Indikator für eine Änderung des Herzinsuffizienzleidens auf einem zusätzlichen respiratorischen Parameter beruht, der aus der Eigenschaft der Atmung bestimmt wird, wobei der zusätzliche respiratorische Parameter ein Apnoe-Hypopnoe-Zählwert und/oder ein Apnoe-Zählwert und/oder eine Atemfrequenz ist.
- Vorrichtung (100) nach Anspruch 1, wobei der Prozessor (114) beruhend auf dem Indikator für eine Änderung des Herzinsuffizienzleidens eine Warnung aktiviert.
- Vorrichtung (100) nach Anspruch 4, wobei die Warnung ein Lichtsignal oder eine elektronische Nachricht umfasst, die übertragen werden soll.
- Vorrichtung (100) nach Anspruch 1, die ferner einen Transmitter aufweist, der mit dem Prozessor (114) gekoppelt ist, wobei der Prozessor (114) ferner konfiguriert ist, das Übertragen einer Nachricht zu steuern, die Daten enthält, die den Indikator des Herzinsuffizienzleidens repräsentieren.
- Vorrichtung (100) nach Anspruch 1, die ferner einen Flussgenerator (424) aufweist, der mit dem Prozessor (114) und der Patientenschnittstelle (102) gekoppelt ist, wobei der Prozessor (114) konfiguriert ist, das Erzeugen eines Flusses eines Atemgases auf einem Druck über dem Luftdruck für die Patientenschnittstelle zu steuern.
- Vorrichtung (100) nach Anspruch 1, wobei der Prozessor (114) konfiguriert ist, den Indikator für eine Änderung des Herzinsuffizienzleidens mit mehreren Schwellenwertvergleichen zu bestimmen, die mehrere respiratorische Parameter einbeziehen, die aus einem Maß des respiratorischen Luftflusses bestimmt werden, und wobei die Eigenschaft der Atmung das Maß des respiratorischen Luftflusses ist.
- Vorrichtung (100) nach Anspruch 8 wobei die respiratorischen Parameter Daten, die für eine oder mehrere Apnoen und Hypopnoen repräsentativ sind, die durch den Patienten durchgemacht werden, und Daten aufweisen, die für eine oder mehrere Cheyne-Stokes-Abschnitte repräsentativ sind, die durch den Patienten durchgemacht werden.
- Vorrichtung (100) nach Anspruch 1, wobei der Prozessor (114) konfiguriert ist, den Indikator für eine Änderung des Herzinsuffizienzleidens mit einem Schwellenwertvergleich zu bestimmen, der ein Oximetrie-Maß einbezieht und wobei die Eigenschaft der Atmung das Oximetrie-Maß ist.
- Vorrichtung (100) nach Anspruch 1, die ferner eine Ultraschallabtastvorrichtung aufweist und wobei der Prozessor (114) konfiguriert ist, einen Indikator für eine Änderung des Herzinsuffizienzleidens beruhend auf Daten zu bestimmen, die durch die Ultraschallabtastvorrichtung bestimmt werden.
- Vorrichtung (100) nach Anspruch 1, wobei der Prozessor (114) konfiguriert ist, einen Indikator für eine Änderung des Herzinsuffizienzleidens beruhend auf einer bestimmten Herzfrequenzvariabilitätsmetrik zu bestimmen.
- Vorrichtung (100) nach Anspruch 1, wobei der Prozessor (114) konfiguriert ist, einen Indikator für eine Änderung des Herzinsuffizienzleidens beruhend auf einem Maß der sympathovagalen Balance zu bestimmen.
- Vorrichtung (100) nach Anspruch 1, wobei der Prozessor (114) konfiguriert ist, einen Indikator für eine Änderung des Herzinsuffizienzleidens beruhend auf einem Gas-Maß des Bluts eines Patienten zu bestimmen, wobei die Vorrichtung (100) vorzugsweise ferner einen Photoploethysmograph aufweist, um das Gas-Maß abzuleiten.
- Vorrichtung (100) nach einem der Ansprüche 1 bis 7, wobei der Indikator für eine Änderung des Herzinsuffizienzleidens die Ermittlung eines Änderungsbetrags des Maßes des respiratorischen Behandlungsdrucks in einer oder mehreren Behandlungssitzungen im Vergleich zu einer oder mehreren früheren Behandlungssitzungen aufweist, und wobei der Indikator für eine Änderung des Herzinsuffizienzleidens vorzugsweise auf einem 95. Perzentilwert des respiratorischen Behandlungsdrucks beruht.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP17201339.3A EP3326524B1 (de) | 2008-07-25 | 2009-07-23 | Vorrichtung zur detektion und behandlung von herzversagen |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US8359608P | 2008-07-25 | 2008-07-25 | |
US12/483,357 US8844525B2 (en) | 2008-07-25 | 2009-06-12 | Method and apparatus for detecting and treating heart failure |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP17201339.3A Division EP3326524B1 (de) | 2008-07-25 | 2009-07-23 | Vorrichtung zur detektion und behandlung von herzversagen |
Publications (2)
Publication Number | Publication Date |
---|---|
EP2147693A1 EP2147693A1 (de) | 2010-01-27 |
EP2147693B1 true EP2147693B1 (de) | 2017-11-15 |
Family
ID=41091826
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP09166164.5A Not-in-force EP2147693B1 (de) | 2008-07-25 | 2009-07-23 | Vorrichtung zur Erkennung und Behandlung von Herzversagen |
EP17201339.3A Active EP3326524B1 (de) | 2008-07-25 | 2009-07-23 | Vorrichtung zur detektion und behandlung von herzversagen |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP17201339.3A Active EP3326524B1 (de) | 2008-07-25 | 2009-07-23 | Vorrichtung zur detektion und behandlung von herzversagen |
Country Status (6)
Country | Link |
---|---|
US (3) | US8844525B2 (de) |
EP (2) | EP2147693B1 (de) |
JP (3) | JP5443875B2 (de) |
CN (2) | CN102961140B (de) |
AU (3) | AU2009202982B2 (de) |
NZ (3) | NZ588615A (de) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP4154804A1 (de) * | 2012-05-30 | 2023-03-29 | ResMed Sensor Technologies Limited | Vorrichtung zur überwachung der herz-lungen-gesundheit |
Families Citing this family (50)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8844525B2 (en) | 2008-07-25 | 2014-09-30 | Resmed Limited | Method and apparatus for detecting and treating heart failure |
US8418692B2 (en) * | 2009-12-04 | 2013-04-16 | Covidien Lp | Ventilation system with removable primary display |
CN106215326B (zh) * | 2010-04-08 | 2019-06-18 | Zoll医疗公司 | 无线通气机报告 |
US8511306B2 (en) | 2010-04-27 | 2013-08-20 | Covidien Lp | Ventilation system with system status display for maintenance and service information |
US8539949B2 (en) * | 2010-04-27 | 2013-09-24 | Covidien Lp | Ventilation system with a two-point perspective view |
US8453643B2 (en) | 2010-04-27 | 2013-06-04 | Covidien Lp | Ventilation system with system status display for configuration and program information |
US8585604B2 (en) | 2010-10-29 | 2013-11-19 | Medtronic, Inc. | Integrated patient care |
US9420959B2 (en) | 2010-12-15 | 2016-08-23 | Cardiac Pacemakers, Inc. | Detecting heart failure by monitoring the time sequence of physiological changes |
US20140076317A1 (en) * | 2011-03-23 | 2014-03-20 | Koninklijke Philips N.V. | Pulse oximetry in respiratory therapy patient interface |
EP3628359A1 (de) * | 2011-04-07 | 2020-04-01 | Fisher & Paykel Healthcare Limited | Steuerung einer elektronischen vorrichtung mit einer beatmungshilfsvorrichtung |
EP3620194B1 (de) | 2011-05-23 | 2022-04-06 | Zoll Medical Corporation | Medizinisches beatmungssystem mit feedbackeinheit für beatmungsqualität |
US9597468B2 (en) | 2011-11-07 | 2017-03-21 | Redmed Limited | Methods and apparatus for providing ventilation to a patient |
AU2013212534B2 (en) | 2012-01-27 | 2015-04-16 | ResMed Pty Ltd | Discrimination of Cheyne-Stokes breathing patterns |
US10525219B2 (en) | 2012-06-26 | 2020-01-07 | Resmed Sensor Technologies Limited | Methods and apparatus for monitoring and treating respiratory insufficiency |
US11129950B2 (en) | 2012-11-19 | 2021-09-28 | The General Hospital Corporation | System and method for monitoring resuscitation or respiratory mechanics of a patient |
US20140247155A1 (en) * | 2013-03-04 | 2014-09-04 | Hello Inc. | Methods using a mobile device to monitor an individual's activities, behaviors, habits or health parameters |
CN105209126A (zh) | 2013-03-15 | 2015-12-30 | 佐尔医药公司 | 处理用于呼吸检测的阻抗信号 |
CN105451648A (zh) * | 2013-08-05 | 2016-03-30 | 心脏起搏器股份公司 | 基于浅快呼吸指数检测心力衰竭的恶化的系统和方法 |
CN105473064B (zh) * | 2013-08-05 | 2018-12-28 | 心脏起搏器股份公司 | 基于潮气量检测心力衰竭的恶化的系统和方法 |
CN103455961A (zh) * | 2013-09-09 | 2013-12-18 | 丁玉兰 | 一种病人高危因素护理评估系统 |
GB2519964A (en) * | 2013-11-01 | 2015-05-13 | Linde Aktiengesellshcaft | Apparatus and method for detecting health deterioration |
FR3021872B1 (fr) * | 2014-06-05 | 2018-07-13 | Koninklijke Philips N.V. | Procede et dispositif de detection au sein d'un dispositif d'assistance respiratoire de l'aggravation de l'etat cardio-respiratoire d'un patient |
US10172568B2 (en) * | 2014-07-14 | 2019-01-08 | Medtronic, Inc. | Determining prospective risk of heart failure hospitalization |
CN106659481A (zh) | 2014-07-22 | 2017-05-10 | 帝人制药株式会社 | 心力衰竭的评价方法和诊断装置 |
EP4012718A1 (de) | 2014-10-24 | 2022-06-15 | ResMed Inc. | System für beatmungsdrucktherapie |
JP6378105B2 (ja) * | 2015-02-05 | 2018-08-22 | シチズン時計株式会社 | 呼吸器疾患の判定装置 |
WO2018031714A1 (en) | 2016-08-11 | 2018-02-15 | Foundry Innovation & Research 1, Ltd. | Systems and methods for patient fluid management |
CN104645471A (zh) * | 2015-02-13 | 2015-05-27 | 齐倩 | 无创小儿持续正压通气呼吸机 |
USD775345S1 (en) | 2015-04-10 | 2016-12-27 | Covidien Lp | Ventilator console |
EP3331426A1 (de) | 2015-08-03 | 2018-06-13 | Foundry Innovation&Research 1, Ltd. | Vorrichtungen und verfahren zur messung von abmessungen, druck und sauerstoffsättigung der vena cava |
WO2017159574A1 (ja) | 2016-03-18 | 2017-09-21 | テルモ株式会社 | 心機能測定装置、心機能測定方法および心機能測定プログラム |
WO2017185128A1 (en) * | 2016-04-26 | 2017-11-02 | Resmed Limited | Diagnosis and monitoring of respiratory disorders |
US11206992B2 (en) | 2016-08-11 | 2021-12-28 | Foundry Innovation & Research 1, Ltd. | Wireless resonant circuit and variable inductance vascular monitoring implants and anchoring structures therefore |
US11701018B2 (en) | 2016-08-11 | 2023-07-18 | Foundry Innovation & Research 1, Ltd. | Wireless resonant circuit and variable inductance vascular monitoring implants and anchoring structures therefore |
JP2019535396A (ja) | 2016-11-10 | 2019-12-12 | ザ リサーチ ファウンデーション フォー ザ ステート ユニバーシティ オブ ニューヨーク | 気道閉塞に関するシステム、方法、及びバイオマーカ |
WO2018220143A1 (en) | 2017-05-31 | 2018-12-06 | Foundry Innovation And Research 1, Ltd | Implantable ultrasonic vascular sensor |
EP3629921A1 (de) | 2017-05-31 | 2020-04-08 | Foundry Innovation & Research 1, Ltd. | Implantierbare sensoren zur gefässüberwachung |
WO2019010112A1 (en) * | 2017-07-05 | 2019-01-10 | Cardiac Pacemakers, Inc. | SYSTEMS AND METHODS FOR MEDICAL ALERT MANAGEMENT |
US10952681B2 (en) * | 2017-09-05 | 2021-03-23 | Medtronic, Inc. | Differentiation of heart failure risk scores for heart failure monitoring |
EP3688770A1 (de) * | 2017-09-28 | 2020-08-05 | Koninklijke Philips N.V. | System und verfahren zur erkennung von schlaganfällen bei patienten während einer druckunterstützungstherapie |
CN111937077B (zh) * | 2018-03-30 | 2024-01-16 | 泰尔茂株式会社 | 管理系统、管理方法及记录介质 |
JP7455815B2 (ja) * | 2018-09-17 | 2024-03-26 | マイカーディオ エルエルシー | 睡眠呼吸障害イベントを分析するためのシステムおよび方法 |
EP3866673A4 (de) * | 2018-10-09 | 2022-09-14 | Inovytec Medical Solutions Ltd. | System zur sofortigen personalisierten behandlung eines patienten in einem medizinischen notfall |
CN113710151A (zh) * | 2018-11-19 | 2021-11-26 | 瑞思迈传感器技术有限公司 | 用于检测呼吸障碍的方法和设备 |
CA3138454A1 (en) * | 2019-04-30 | 2020-11-05 | Norton (Waterford) Limited | Inhaler system |
CN110811591A (zh) * | 2019-10-31 | 2020-02-21 | 太原理工大学 | 一种基于心率变异性的心力衰竭分级方法 |
CN111700601B (zh) * | 2020-06-28 | 2022-06-07 | 福建省立医院 | 心衰管理仪及心衰管理系统 |
CN112169114A (zh) * | 2020-10-31 | 2021-01-05 | 湖南万脉医疗科技有限公司 | 一种心肺耦合辅助呼吸器 |
CN116600844A (zh) * | 2020-11-17 | 2023-08-15 | 深圳迈瑞生物医疗电子股份有限公司 | 呼吸支持设备、监护设备、医疗设备系统及参数处理方法 |
EP4369355A1 (de) * | 2022-11-11 | 2024-05-15 | Löwenstein Medical Technology S.A. | Datenkommunikation zwischen einem beatmungsgerät und mindestens einer datenverarbeitungseinrichtung |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040134496A1 (en) * | 2003-01-10 | 2004-07-15 | Cho Yong K. | Method and apparatus for detecting respiratory disturbances |
Family Cites Families (52)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS59107399A (ja) * | 1982-12-13 | 1984-06-21 | リオン株式会社 | 鼻音化の程度を計測する方法 |
US5020516A (en) * | 1988-03-31 | 1991-06-04 | Cardiopulmonary Corporation | Circulatory assist method and apparatus |
US4958638A (en) * | 1988-06-30 | 1990-09-25 | Georgia Tech Research Corporation | Non-contact vital signs monitor |
US5259373A (en) * | 1989-05-19 | 1993-11-09 | Puritan-Bennett Corporation | Inspiratory airway pressure system controlled by the detection and analysis of patient airway sounds |
US5580722A (en) * | 1989-07-18 | 1996-12-03 | Oncogene Science, Inc. | Methods of determining chemicals that modulate transcriptionally expression of genes associated with cardiovascular disease |
US5188098A (en) * | 1991-11-04 | 1993-02-23 | The Trustees Of The University Of Pennsylvania | Method and apparatus for ECG gated ventilation |
US20050062609A9 (en) * | 1992-08-19 | 2005-03-24 | Lynn Lawrence A. | Pulse oximetry relational alarm system for early recognition of instability and catastrophic occurrences |
US5353788A (en) * | 1992-09-21 | 1994-10-11 | Miles Laughton E | Cardio-respiratory control and monitoring system for determining CPAP pressure for apnea treatment |
JP2770694B2 (ja) * | 1993-01-13 | 1998-07-02 | 松下電器産業株式会社 | 生体情報処理装置 |
EP0934723B1 (de) * | 1993-11-05 | 2004-09-22 | ResMed Limited | Regelung bei einer Behandlung mit kontinuierlichem positiven Atemwegsdruck |
US5535738A (en) * | 1994-06-03 | 1996-07-16 | Respironics, Inc. | Method and apparatus for providing proportional positive airway pressure to treat sleep disordered breathing |
US6932084B2 (en) * | 1994-06-03 | 2005-08-23 | Ric Investments, Inc. | Method and apparatus for providing positive airway pressure to a patient |
US5794615A (en) * | 1994-06-03 | 1998-08-18 | Respironics, Inc. | Method and apparatus for providing proportional positive airway pressure to treat congestive heart failure |
US6105575A (en) * | 1994-06-03 | 2000-08-22 | Respironics, Inc. | Method and apparatus for providing positive airway pressure to a patient |
GB9422224D0 (en) * | 1994-11-03 | 1994-12-21 | Brain Archibald Ian Jeremy | A laryngeal mask airway device modified to detect and/or stimulate mescle or nerve activity |
AUPN236595A0 (en) | 1995-04-11 | 1995-05-11 | Rescare Limited | Monitoring of apneic arousals |
US5740797A (en) * | 1996-02-23 | 1998-04-21 | University Of Massachusetts | Cardiac synchronized ventilation |
EP0891199B1 (de) * | 1996-03-08 | 1999-09-08 | Medisize BV | Vorrichtung und verfahren zur überwachung von atemkennwerten eines beatmungssystems |
US6062216A (en) * | 1996-12-27 | 2000-05-16 | Children's Medical Center Corporation | Sleep apnea detector system |
JP2001525706A (ja) | 1997-05-16 | 2001-12-11 | レスメッド・リミテッド | 呼吸分析システム |
US20050121033A1 (en) * | 1998-02-25 | 2005-06-09 | Ric Investments, Llc. | Respiratory monitoring during gas delivery |
AUPP366398A0 (en) * | 1998-05-22 | 1998-06-18 | Resmed Limited | Ventilatory assistance for treatment of cardiac failure and cheyne-stokes breathing |
JP3057438B2 (ja) * | 1998-09-11 | 2000-06-26 | 日本アビオニクス株式会社 | 非接触式心肺機能監視装置 |
AUPP783198A0 (en) * | 1998-12-21 | 1999-01-21 | Resmed Limited | Determination of mask fitting pressure and correct mask fit |
DE60039497D1 (de) | 1999-02-03 | 2008-08-28 | Mermaid Care As | Automatische lungenparameterschätzung |
US6467477B1 (en) * | 1999-03-26 | 2002-10-22 | Respironics, Inc. | Breath-based control of a therapeutic treatment |
US6401713B1 (en) | 1999-05-05 | 2002-06-11 | Respironics, Inc. | Apparatus and method of providing continuous positive airway pressure |
AU6064000A (en) * | 1999-06-30 | 2001-01-31 | University Of Florida | Ventilator monitor system and method of using same |
JP2002058659A (ja) * | 2000-08-18 | 2002-02-26 | Micro Wave Lab:Kk | マイクロ波微動センサー |
US6752151B2 (en) * | 2000-09-25 | 2004-06-22 | Respironics, Inc. | Method and apparatus for providing variable positive airway pressure |
DE10103973A1 (de) * | 2001-01-30 | 2002-08-01 | Peter L Kowallik | Verfahren und Vorrichtung zur Schlafüberwachung |
FR2829917B1 (fr) | 2001-09-24 | 2004-06-11 | Ela Medical Sa | Dispositif medical actif comprenant des moyens de diagnostic du profil respiratoire |
WO2004013611A2 (en) * | 2002-08-01 | 2004-02-12 | California Institute Of Technology | Remote-sensing method and device |
US8251061B2 (en) * | 2003-09-18 | 2012-08-28 | Cardiac Pacemakers, Inc. | Methods and systems for control of gas therapy |
WO2005037355A1 (en) | 2003-10-17 | 2005-04-28 | Resmed Limited | Methods and apparatus for heart failure treatment |
US7314451B2 (en) * | 2005-04-25 | 2008-01-01 | Earlysense Ltd. | Techniques for prediction and monitoring of clinical episodes |
WO2005096729A2 (en) * | 2004-03-31 | 2005-10-20 | Resmed Limited | Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing |
US7575005B2 (en) * | 2004-05-18 | 2009-08-18 | Excel-Tech Ltd. | Mask assembly with integrated sensors |
AU2005291858B2 (en) * | 2004-10-06 | 2011-07-28 | Resmed Limited | Method and apparatus for non-invasive monitoring of respiratory parameters in sleep disordered breathing |
NZ554108A (en) | 2004-12-23 | 2012-04-27 | Resmed Ltd | Apparatus and method of diagnosis of Cheyne-Stokes breathing in a person |
US8992436B2 (en) * | 2005-09-16 | 2015-03-31 | Cardiac Pacemakers, Inc. | Respiration monitoring using respiration rate variability |
US7775983B2 (en) * | 2005-09-16 | 2010-08-17 | Cardiac Pacemakers, Inc. | Rapid shallow breathing detection for use in congestive heart failure status determination |
US7766840B2 (en) * | 2005-12-01 | 2010-08-03 | Cardiac Pacemakers, Inc. | Method and system for heart failure status evaluation based on a disordered breathing index |
US7761158B2 (en) * | 2005-12-20 | 2010-07-20 | Cardiac Pacemakers, Inc. | Detection of heart failure decompensation based on cumulative changes in sensor signals |
US7896813B2 (en) * | 2006-03-31 | 2011-03-01 | Medtronic, Inc. | System and method for monitoring periodic breathing associated with heart failure |
CN101069762A (zh) * | 2006-05-08 | 2007-11-14 | 华润集团有限公司 | 针对特殊人群的呼吸器系统 |
EP3616611B1 (de) * | 2006-06-01 | 2020-12-30 | ResMed Sensor Technologies Limited | Vorrichtung und verfahren zur überwachung physiologischer zeichen |
US8050765B2 (en) * | 2006-08-30 | 2011-11-01 | Cardiac Pacemakers, Inc. | Method and apparatus for controlling neural stimulation during disordered breathing |
JP4962947B2 (ja) * | 2006-10-19 | 2012-06-27 | 株式会社タウ技研 | 非接触診断装置 |
US7945924B2 (en) | 2007-11-15 | 2011-05-17 | At&T Intellectual Property I, L.P. | Detecting distribution of multimedia content |
EP2265169A4 (de) * | 2008-04-03 | 2013-01-09 | Kai Medical Inc | Kontaktlose physiologische bewegungssensoren und anwendungsverfahren |
US8844525B2 (en) | 2008-07-25 | 2014-09-30 | Resmed Limited | Method and apparatus for detecting and treating heart failure |
-
2009
- 2009-06-12 US US12/483,357 patent/US8844525B2/en active Active
- 2009-07-23 CN CN201210450669.1A patent/CN102961140B/zh not_active Expired - Fee Related
- 2009-07-23 AU AU2009202982A patent/AU2009202982B2/en not_active Ceased
- 2009-07-23 CN CN2009101646443A patent/CN101642367B/zh not_active Expired - Fee Related
- 2009-07-23 EP EP09166164.5A patent/EP2147693B1/de not_active Not-in-force
- 2009-07-23 EP EP17201339.3A patent/EP3326524B1/de active Active
- 2009-07-24 JP JP2009173105A patent/JP5443875B2/ja active Active
- 2009-07-24 NZ NZ588615A patent/NZ588615A/xx unknown
- 2009-07-24 NZ NZ578601A patent/NZ578601A/en unknown
- 2009-07-24 NZ NZ600936A patent/NZ600936A/xx unknown
-
2013
- 2013-12-19 JP JP2013262043A patent/JP5913274B2/ja active Active
-
2014
- 2014-08-06 AU AU2014210589A patent/AU2014210589B2/en not_active Ceased
- 2014-08-27 US US14/469,866 patent/US20140364706A1/en not_active Abandoned
-
2015
- 2015-09-23 AU AU2015230749A patent/AU2015230749B2/en not_active Ceased
- 2015-12-03 JP JP2015236266A patent/JP6387336B2/ja active Active
-
2020
- 2020-02-28 US US16/805,038 patent/US20200268279A1/en active Pending
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040134496A1 (en) * | 2003-01-10 | 2004-07-15 | Cho Yong K. | Method and apparatus for detecting respiratory disturbances |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP4154804A1 (de) * | 2012-05-30 | 2023-03-29 | ResMed Sensor Technologies Limited | Vorrichtung zur überwachung der herz-lungen-gesundheit |
US11850077B2 (en) | 2012-05-30 | 2023-12-26 | Resmed Sensor Technologies Limited | Method and apparatus for monitoring cardio-pulmonary health |
Also Published As
Publication number | Publication date |
---|---|
AU2014210589A1 (en) | 2014-08-28 |
NZ578601A (en) | 2011-10-28 |
JP5443875B2 (ja) | 2014-03-19 |
NZ600936A (en) | 2013-10-25 |
NZ588615A (en) | 2012-10-26 |
US20100018530A1 (en) | 2010-01-28 |
AU2015230749A1 (en) | 2015-10-15 |
AU2014210589B2 (en) | 2015-07-30 |
CN102961140A (zh) | 2013-03-13 |
EP3326524B1 (de) | 2020-07-01 |
EP2147693A1 (de) | 2010-01-27 |
JP2014064951A (ja) | 2014-04-17 |
AU2009202982A1 (en) | 2010-02-11 |
JP5913274B2 (ja) | 2016-04-27 |
US20140364706A1 (en) | 2014-12-11 |
US8844525B2 (en) | 2014-09-30 |
AU2015230749B2 (en) | 2017-05-25 |
JP2016073674A (ja) | 2016-05-12 |
JP6387336B2 (ja) | 2018-09-05 |
AU2009202982B2 (en) | 2014-08-14 |
EP3326524A1 (de) | 2018-05-30 |
JP2010075674A (ja) | 2010-04-08 |
CN101642367B (zh) | 2012-12-26 |
US20200268279A1 (en) | 2020-08-27 |
CN101642367A (zh) | 2010-02-10 |
CN102961140B (zh) | 2015-09-30 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20200268279A1 (en) | Method and apparatus for detecting and treating heart failure | |
US11191912B2 (en) | Methods and apparatus for detecting and treating respiratory insufficiency | |
US10610167B2 (en) | Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing | |
EP1729841B1 (de) | Vorrichtung zur überwachung des kardiovaskulären zustands von patienten mit schlafbezogenen atmungsstörungen | |
JP2019506920A (ja) | 睡眠の質及び無呼吸−低呼吸指数観察システム |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
|
AK | Designated contracting states |
Kind code of ref document: A1 Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO SE SI SK SM TR |
|
AX | Request for extension of the european patent |
Extension state: AL BA RS |
|
17P | Request for examination filed |
Effective date: 20100723 |
|
17Q | First examination report despatched |
Effective date: 20150717 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: EXAMINATION IS IN PROGRESS |
|
GRAP | Despatch of communication of intention to grant a patent |
Free format text: ORIGINAL CODE: EPIDOSNIGR1 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: GRANT OF PATENT IS INTENDED |
|
INTG | Intention to grant announced |
Effective date: 20170518 |
|
GRAS | Grant fee paid |
Free format text: ORIGINAL CODE: EPIDOSNIGR3 |
|
GRAA | (expected) grant |
Free format text: ORIGINAL CODE: 0009210 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE PATENT HAS BEEN GRANTED |
|
AK | Designated contracting states |
Kind code of ref document: B1 Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO SE SI SK SM TR |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: EP Ref country code: GB Ref legal event code: FG4D Ref country code: AT Ref legal event code: REF Ref document number: 945666 Country of ref document: AT Kind code of ref document: T Effective date: 20171115 |
|
REG | Reference to a national code |
Ref country code: IE Ref legal event code: FG4D |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R096 Ref document number: 602009049342 Country of ref document: DE |
|
REG | Reference to a national code |
Ref country code: NL Ref legal event code: MP Effective date: 20171115 |
|
REG | Reference to a national code |
Ref country code: LT Ref legal event code: MG4D |
|
REG | Reference to a national code |
Ref country code: AT Ref legal event code: MK05 Ref document number: 945666 Country of ref document: AT Kind code of ref document: T Effective date: 20171115 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: LT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: SE Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: ES Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: FI Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: NO Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20180215 Ref country code: NL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: LV Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: GR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20180216 Ref country code: PT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20180315 Ref country code: BG Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20180215 Ref country code: HR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: AT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 |
|
REG | Reference to a national code |
Ref country code: FR Ref legal event code: PLFP Year of fee payment: 10 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: DK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: SK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: CY Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: EE Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: CZ Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R097 Ref document number: 602009049342 Country of ref document: DE |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: PL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: SM Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: IT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: RO Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: FR Payment date: 20180612 Year of fee payment: 10 |
|
PLBE | No opposition filed within time limit |
Free format text: ORIGINAL CODE: 0009261 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT |
|
26N | No opposition filed |
Effective date: 20180817 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: DE Payment date: 20180710 Year of fee payment: 10 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: SI Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: PL |
|
GBPC | Gb: european patent ceased through non-payment of renewal fee |
Effective date: 20180723 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: MC Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 Ref country code: LU Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180723 |
|
REG | Reference to a national code |
Ref country code: BE Ref legal event code: MM Effective date: 20180731 |
|
REG | Reference to a national code |
Ref country code: IE Ref legal event code: MM4A |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: GB Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180723 Ref country code: LI Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180731 Ref country code: IE Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180723 Ref country code: CH Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180731 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: BE Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180731 |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R082 Ref document number: 602009049342 Country of ref document: DE Representative=s name: VOSSIUS & PARTNER PATENTANWAELTE RECHTSANWAELT, DE Ref country code: DE Ref legal event code: R081 Ref document number: 602009049342 Country of ref document: DE Owner name: RES MED PTY LTD, BELLA VISTA, AU Free format text: FORMER OWNER: RESMED LIMITED, BELLA VISTA, NEW SOUTH WALES, AU |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: MT Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20180723 |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R119 Ref document number: 602009049342 Country of ref document: DE |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: TR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20171115 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: DE Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20200201 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: HU Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT; INVALID AB INITIO Effective date: 20090723 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: MK Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20171115 Ref country code: FR Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20190731 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: IS Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20180315 |